Expenditure Pattern for TB Treatment among Patients Registered in an Urban Government DOTS Program in Chennai City, South India

Abstract

Background. Tuberculosis (TB) patients registered in the government clinics under the DOTS (Directly Observed Treatment, Short Course) program in Chennai city catering to about 4.3 million population. Objective. To estimate the pattern and overall costs incurred by the new patients (who have never had treatment for tuberculosis or have taken antituberculosis drugs for less than one month) registered under DOTS program in the treatment of tuberculosis in Chennai city. Methodology. A cross-sectional survey among new TB patients, who had completed intensive phase of antituberculosis treatment, was done using a precoded semi-structured questionnaire between March and June 2007. Information was collected on demographic, socioeconomic characteristics and expenditure for before and during treatment. Mean costs were used for comparison. Results. Among the 300 TB patients, most economically productive age group and 186 (62%) were males. The overall estimated total costs incurred right from the onset of symptoms until treatment completion was found to be Rs. 3211 (3.8% of annual family income) under DOTS program, which is less compared to previous studies. The overall mean total cost was significantly high among male (Rs. 3270; P < 0.01), employed (Rs. 3945; P < 0.01), and extrapulmonary patients (Rs. 3915; P < 0.01). Conclusion. The study has reiterated the fact that DOTS helps in reducing out-of-pocket expenses to patients with tuberculosis and hence is a cost-effective health intervention. This cost reduction may help to increase the access to the poor people which would help in achieving universal access to TB care services.

Catastrophic costs of tuberculosis care: a mixed methods study from Puducherry, India

“…[14]. Another study from Chennai, India reported a mean total cost of US$48 [9]. Mean total costs for TB care in South Africa and Nigeria were US$207 and $157 respectively [15,16].…”

“…Assuming the mean (SD) of total cost incurred by patients towards TB diagnosis and treatment as INR 3000 (100) [9], a minimum of 104 individuals were required for the study. All eligible participants were approached serially for the study and included until the desired sample size was reached.…”

Universal Public Finance of Tuberculosis Treatment in India: An Extended Cost‐Effectiveness Analysis

“…For example, working days lost due to TB can range from 30 to 90 in South India (Muniyandi et al ., ; Muniyandi et al ., ). Subsequent indirect costs from loss of earnings can be substantial (Ananthakrishnan et al ., ), which would—in the absence of other forms of social insurance—importantly increase the insurance benefits provided by UPF. Third, there is a lack of a detailed description and corresponding pricing of the existing underlying mix of public versus private providers of TB treatment.…”

Spatial-temporal Analysis of Tuberculosis Incidence in Burundi Using GIS

“…Tuberculosis (TB) disease is one of major global public health problems [1,2], with almost 1.6 million deaths in 2017 [3]. TB leads usually to enormous socioeconomic disturbance and hinders nation's development [4]. In this context, positive correlation was noticed between declining TB incidence rate and human development index [5].…”